HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
CSU" ry
F L O R I D A
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 8421 S US HWY 1 ( TINT CITI 8445)
Legal Description: LUCIE GARDENS263640BLK 3 TRATPARTOF LOTS5,6AND7 MPDAF: BEGAT INTOF WU SR SAND N LI LOT6 RUNS 27 DEG 31 MIN40SECE465FT, TH S62DEG28 MIN20 SECW350 FTTH N 27
DEG 31 MIN 40 SEC W 390.44 FT, TH N 89 DEG 59 MIN 41 SEC W 142.87 Ff, TH N 00 DEG 00 MIN 19 SEC E 230 FT TON LI SD LOT 7, TH ELY ALG SD N LI418.77 FT TO W R/W LI SR 5 AND POB -LESS N 20 FT- (4.72 AC) (OR 3676-2152)
Property Tax ID #: 3414-501-1905-050-4
Site Plan Name: TINT CITI
Project Name: TINT CITI
Setbacks Front Back: _
Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: I
provide electrical wiring for lift for Tint Citi at 8445 S US HWY 1
CONSTRUCTION INFORMATION:
Additional work to(ei3er ormed under this permit— check all apply:
HVAC Gas Tank F]Gas Piping Shutters []Windows/Doors
❑✓ Electric ❑ Plumbing Sprinklers Generator D Roof Roof pitch
Total Sq. Ft of Construction:.
Cost of Construction: $ 2300
S Ft. of First Floor: _
Utilities:cn Sewer F] Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name St Lucie Palm Plaza LLC
Name: Donald B Green
Address: 23 Chauncey PI
Company: Don Green Electric
City: Woodbury State: NY
Zip Code: 11797 Fax:
Phone No.
Address: 1305 W 1 st Street `
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No. 772-418-57.9
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: dongreenelectdc@gmail.com
State or County License: EC13007447
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requires.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable
Name:
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
BONDING COMPANY: X Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that 1 will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me
this day of �' , 20 G -by
ure ofVlotary Public- State of
Personally Knowe OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
JOY CHRISTINE COPELAND
EXPIRES: JAN 05, 2020
Banded through 1st State Insurance
The forgoing instru t was acknowledged before me
this day of 20 L3 by
Notary public- State of
Personally Known — OR Produced Identification
Type of Identification Produced
Commission No. vP JOYCHRISTINECOPELAND
OSIR. _ LB
MY COMMISSION #FF948042
Bonded through 1 st State Insurance
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